The Newton Group, Inc.
The Newton Group, Inc.
Online Contact Lens Order Form
Newton Account #:
Office Name:
Ordered By:
Phone #:
Email Address:

The Email Address you use, should be the one you would like a confirmation returned to!
The TR checkbox should be checked if the item you are ordering is Trial Lenses.
The D/S checkbox should be checked to Drop Ship lenses. Then type the line #, full name, and address in Special Instructions.
Manufacturer
Product Line
 TR
Color
Base
Dia
Power
Cyl
Axis
Add
Qty
Patient Name
D/S
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Special Instructions
The Special Instructions box allows you to add additional order processing info such as "Drop Ship" addresses, etc.

Confirm
(Visually confirm your order, then click Confirm, then click Submit to send your order.)
NOTE - Please click on the "Submit Order" button ONE TIME ONLY.
This process could take up to 90 seconds to complete. Please be patient. A confirmation page will be displayed upon completion.